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    Question Critical Incident Stress Debriefing Question

    Friends,

    For a time now debate has been brewing on whether or not debriefings after a critical indicent, disaster and mass casualty indicent helps First Responders handle work related stress. I am currently working on a project with the Department of Homeland Security's center for studying terrorism and response to natural disasters and I would like to know your thoughts and concerns about debriefing in hopes that I can relay this information to our people in Washington and work on improving the way we respond to indicents.

    Thanks for all your help and stay safe!

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    Having attended quite a few of the CISD things, I have seen some participants that think their all B.S. and some who thought it helped. Personally I have yet to have any issues with bad calls but I cannot directly attribute this to the CISD process. Maybe the ones I went to helped me with some unknown issue or maybe I've yet to truly have an issue since I've also not attended CISD for every "bad" call I've been to. As I've been told by participants that they felt better, I'll continue to attend if not for me, to at least support those who might feel it necessary.

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    Quote Originally Posted by RFDACM02 View Post
    As I've been told by participants that they felt better, I'll continue to attend if not for me, to at least support those who might feel it necessary.
    Nice work supporting those around you. Sometimes I think we fail to take notice of those around us, who although we might handle something fine, may take issue with it. Everyone has their own demons that get to them.

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    My personal thoughts are having a program and debreifing in place that only helps a few, is a lot better than having nothing in place that helps no one. Being there as a support to others is a great idea; even if you feel you may not benefit, others will, thanks to your support of them and the system.

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    We had a fire two days before x-mas where 6 people died. They had everyone that worked that day sit for a CISD thing. I was perfectly fine until I sat for that. They sat everyone in a circle and made them describe everything that they did at that fire. I didn't have kids at the time and the fire didn't bother me. Seeing all of the guys with kids break down while telling their story bothered the hell out of me. Unless I am ordered to, with a threat of termination, I will never sit through one again. If something gets to me I will get help on my own. If I don't see it bothering me, my wife certainly will and will let me know. My department just sent a bunch of guys to be peer counselors. Can't say I would ever sit with any of them and tell them of problems either.

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    Quote Originally Posted by cfdeng3 View Post
    We had a fire two days before x-mas where 6 people died. They had everyone that worked that day sit for a CISD thing. I was perfectly fine until I sat for that. They sat everyone in a circle and made them describe everything that they did at that fire. I didn't have kids at the time and the fire didn't bother me. Seeing all of the guys with kids break down while telling their story bothered the hell out of me. Unless I am ordered to, with a threat of termination, I will never sit through one again. If something gets to me I will get help on my own. If I don't see it bothering me, my wife certainly will and will let me know. My department just sent a bunch of guys to be peer counselors. Can't say I would ever sit with any of them and tell them of problems either.

    I agree with the brother from Cranston. I have been in both scenerios- I have been forced to attend sessions, and I have attended them voluntarily. And been forced/attended voluntarily as both a career FF and as a volunteer.

    I got nothing out of the ones I was forced to attend. I wanted nothing to do with them, and did not have any ill afterthoughts. The ones I attended voluntarily I got something out of.

    CISD has it's place. But ordering/forcing members to attend is not an answer.
    "Loyalty Above all Else. Except Honor."

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    Angry Wtf?

    As both a firefighter and a trauma counselor, I'd like to say WHAT THE F!@$! to any fire department that forces everyone to automatically go to CISD sessions. Yeah, I recommend going, but if it isn't for you, so be it.

    There also needs to be ALOT more training for the counselors and not just out of books. I give all the Storm King survivors mad props for walking out when the jackass shrink started telling them the steps of the grieving process they were supposed to experience. I love that they then went to the bar, ran up a huge tab and charged it to the shrink's hotel room.

    My question for everyone is this: Would you be more likely to go to sessions with someone you knew had been through the same traumas and actually understood what they were talking about? Or is having peer counselors pointless?

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    I must say that in our area, no one is forced to attend and in fact the group who handles the CISD will say that over and over between the first contact to request the CISD until minutes before the session begins. Most times there are people who don't speak, or will speak on the factual parts that they witnessed and did but elect to not discuss their personal feelings parts. I do know some that would not attend another again for fear that it caused them to overthink the incident. To each there own, in this case. Like I said, I go in large part to show support and in hopes that if one guy (or gal) doesn't want to attend for fear of being less macho or whatever, they'll have another career firefighter there. We have heard many career guys say its for babies or vollies who can't handle the job.

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    Google it.

    There are several recent studies that show that such things have the potential to do more harm than good.

    "Mandatory" sessions are a complete joke.

    If it's voluntary and people choose to avail themselves of it, hey, have at it.
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    Quote Originally Posted by Resq14 View Post
    Google it.

    There are several recent studies that show that such things have the potential to do more harm than good.
    It seems that this issue is the counselor/shrinks "smoothbore vs. fog debate". We had a lady come offer to tap our personnel on the forehead while they talked aloud about "bad call" and it would release the demons. We kindly sent her to the Police Station citing they deal with demons more often than us!

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    Well... here goes. Firstly, since moving to FX Co, I have not had the need/requirement to attend any CISD debriefs. However. At the "Old Place", I had opportunity/directive to attend 4x. I say "directive" because the Chief was always on the ball, and in each occasion, the counsellor was always ready and waiting for us on our return from whatever call it was.

    First debrief was for a logger who (working on his own) got his head caught in some wood processing (read hydraulic wood splitter) machinery. He was found in the Back 40 by some hikers. When we found him, his head was kinda squished (not smashed - did not break skin) in a hydraulic ram. Coroner figured he'd been like that for about 24 hrs. Due to logistics, the cop I was riding with left me behind with "him" while going off to lead the rest of the pack to the site. Let me just finish this one off by saying that when you are alone with a corpse, even in the wide open woods, when a cell phone that is not your rings...... how high is "Orbit"?

    Number two was a cardiac arrest - 70+ YOM - he'd been like that for about 12 -14 hrs before the neighbours decided to check on him.

    Number 3 was a multi-car MVI in which the driver of the very badly smashed Volvo became much taller - I am pretty sure that in real life he was not 6'7", with a face looking like a basketball.

    Last one was a two car MVI. Lead vehicle was a Jimmy S10 type with Mom, Dad a 9 and 4 YO. They got rear-ended at highway speeds from a F150 extended cab. Both vehicles caught fire, with the Jimmy becoming fully involved after it bounced off the road. Fortuanately some well placed off duty paramedics, fire personnel and a nurse or three happened to be the first cars on scene and were able to accomplish emergency extrications of the family. In the end, the 9YOF succumed to her injuries, about 4 weeks later.

    The point I am trying to make is that the Chief I had then was very proactive regarding CISD (there had been a very tragic suicide event a few years before my time, that caused some serious administrative problems) and any serious trauma event had him request that a councellor be present during our debriefings (we debriefed after every significant event) and while it could be considered "voluntary" we were all encouraged (and all did) attend. We were also afforded individual councelling if we felt the need.

    From a personal point of view, I think it is a good thing. I know that it is not for everyone to share his/her feelings but for those who do need that kind of support, they should have the support of the entire crew. However, should it be strictly "enforced" by Chief's Decree? No, I dont think so, but I do feel that for the good of all, and in particular those who really do need that kind of after action contact, everyone who was involved with the incident should do his/her little bit to help those who need it.

    I hope that made sense.
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    Quote Originally Posted by aggieman07 View Post
    Friends,

    For a time now debate has been brewing on whether or not debriefings after a critical indicent, disaster and mass casualty indicent helps First Responders handle work related stress. I am currently working on a project with the Department of Homeland Security's center for studying terrorism and response to natural disasters and I would like to know your thoughts and concerns about debriefing in hopes that I can relay this information to our people in Washington and work on improving the way we respond to indicents.

    Thanks for all your help and stay safe!
    I would say it works for some people and not for other people. The important part is that it should be available though.

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    I have been o two of them. Both were voluntary, my department does not force anyone to attend, just strongly recommend it. The first was for a fire about 3 years ago Christmas morning where we had a triple fatality (all members of the same family), the second was about 2 years ago, fire in a nursing home, 9 fatalaties. Both times I chose to go. I would say they helped a great deal but they were not the only thing. The support from the other guys at the house, from my wife, friends, that combined with CISD without a doubt helped. If your in the situation I would suggest going to one, it may help it may not, but attempting could never hurt. Stay safe.
    Gary
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    I went, I cried, I felt better and got over it. I move on. It works.
    Save forcing for the Chief and entry team. It's their job.
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    Exclamation Well.........

    Some good posts here. I agree, "Forcing" someone to attend a CISD event is NOT the way to do business. I've seen my share of tough calls, one of which was the Pickup truck crash that killed 10 (yes Ten) Teenagers back in 1978, near my community. But, I don't have any problems dealing with stuff like this, and the few CISD events that I have attended have not had any effect on me, one way or the other. Having said that, I WILL attend any event where my presence may help someone else. The Troops come first.
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    When I was chief of our department, I made CISD available to those who might need it. I say "might need it" because any newbie who hasn't recently seen a decapitation up close and personal might have a problem with dealing with it.
    Fortunately, many of the counselors on the team we used were friends of mine and had been on the job as firefighters, ER doctors and trauma nurses for quite some time, so they connected with us.
    Many claim that going to incidents where kids are involved are the hardest, but unless you were born without a heart, any single event can become an emotion that explodes into unusual behavior.
    I saw my share over 22 years and to be honest, I worry more about the "cumulative" effect more than the single event.
    CISD has both good and bad elements. It can become too "critical" at times focusing on the negatives. Anger can rear its ugly head to the point that grudges may be held.
    I am against forcing anyone to attend and I also deplore strictly a "clinical" rendering.
    If a department has a good support network, then you can talk things through most of the time. However; never assume everyone is "OK". You have to have some knowledge of human behavior and be capable of noticing if someone is having a problem. They may need help and if you aren't equipped internally, they you may need to use CISD.
    Don't assume that CISD is the fix all. Monitoring your people even after CISD is prudent.
    And to believe that using it is a sign of weakness is foolish.
    We are not our fathers. It's OK to show emotion and to seek help if need be.
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    In my nearly 30 years in the fire service, I've been to so many incidents that could have had CISD utilized that I can't remember them all. Early on in my career, I don't think we had anything like that available to us. Mainly, if we had a particularly gruesome or stressful call, it was us just sitting around talking it out amongst ourselves when all was said and done.

    Over the last 15+ years, we've had a dedicated CISD team along with several peer counselors. I personally have never felt the need to speak to anyone about any of the calls I've been on. Just a preference, don't think it would be useful to me. I get more comfort from talking it over with my crew, if you want to call it comfort. I also think it stems from the fact that I have a very firm belief in what is to come after this life.

    I'm not saying there is no place for CISD, I know several people who have benefited by using it, from what I've been told. I think of it as a tool that if used properly by those who need it can be of benefit.

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    What works for some does'nt work for others. It's a complex issue and forcing people to attend debriefs is not the answer. However I think it's important to have the support there for those fire fighters and family of fire fighters (emergency personnel) when they wish to use it. Plus, have those people aware that it is there for them. I've seen a lot of hurt done with the best of intentions. At the end of the day it's up to the individual to want to deal with it. Personally, I think its a good thing and it's better than nothing.

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    Thanks go to Chief Reason for a reminder, that I should have included in my earlier post. The councellor that the Cowichan Valley Regional District employs for CISD debriefings is a former firefighter from the local area - as I would hope that all CISD councellors would be "bred from the fires" so to speak. Talking with someone who has B-T-D-T-G-Tshirt is easier than, as it was put in another thread, someone who only has "12 years of student loans" behind him...."
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    I believe RFDACM02 summed it up, if your an officer and you don't want to go but some of your troops are going you should attend for support of them.

    I have seen some where the counsler wants to probe and hear all the gruesome details instead of just letting the guys say there piece, I wanted to call B.S. but kept my mouth shut. I find humor as relief when you get back and are cleaning up from the call, try to get your mind off it and move on.

    We usually only do them now when children are involved this seems to be more of an issue with most folks.

    Burn
    Burn<br />LT/EMT/Inst />Central Mat-Su FD<br />Wasilla Alaska

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    I believe that if a debriefing or defusing is done properly it can be very effective. However, if it is not conducted as an organized process it can turn out to be a bunch of finger pointing and cause for hard feelings. One of the first and most important things is that it should be clearly defined before the meeting starts that it is not a finger pointing session and not a "I would have done it this way..." session.

    I have witnessed sessions where people "thought" they were fine with the events of the "bad call" and when they discussed the incident again they found out that they truly were not over the issue and still had problems. Later they expressed that it helped a lot to talk about the call.

    Basically, lose the macho tough guy attitudes and support those around you and dont kid yourself that things dont affect you. I used to be that way and have seen first hand the B.S. is in yourself.

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    Default totally agree

    Just ask the experts. The real experts Doctors and shrinks and they will tell you that research shows it causes more harm than good.
    Don't believe me

    Do like he said Google it







    Quote Originally Posted by Resq14 View Post
    Google it.

    There are several recent studies that show that such things have the potential to do more harm than good.

    "Mandatory" sessions are a complete joke.

    If it's voluntary and people choose to avail themselves of it, hey, have at it.

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    Though I don't support mandatory debriefing, I still find it interesting that some still believe that it is a sign of weakness to discuss your feelings in a group setting such as critical incident stress debriefing.
    Talking with peers about a particularly troubling call is always a good idea. If you don't, you'll cook from the inside out.
    I attended a couple in 22 years.
    I still find myself having dreams and re-visiting some of the skeletons 5 years after retiring from active firefighting.
    But then, I'm a tough guy.
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    Quote Originally Posted by ChiefReason View Post
    Monitoring your people even after CISD is prudent.
    It's more than just prudent IMO, it's essential.
    I had a bad call involving a deceased 1 month old, on Father's Day no less, and we went over it that day. I thought I was fine, just one of a hundred dead babies I'd seen. Well, I WAS fine until the next morning when I got home and my wife and kids came running up to Daddy...

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    Quote Originally Posted by JJensenJr View Post
    It's more than just prudent IMO, it's essential.
    I had a bad call involving a deceased 1 month old, on Father's Day no less, and we went over it that day. I thought I was fine, just one of a hundred dead babies I'd seen. Well, I WAS fine until the next morning when I got home and my wife and kids came running up to Daddy...
    I can relate.
    Every time we cut dead teens out of what was left of the vehicle, I would get home, kiss my wife and hug my teen. One of my worst reactions to an incident was the day we took two dead out of a Ford Festiva. They had JUST graduated high school. It was just so very senseless and tragic. The driver crossed the center line because he became distracted and struck an oncoming vehicle head on, killing that driver. Triple fatality-two dead teens and one dead senior citizen.
    And on a day that was in the 90s.
    I can still smell that "smell" to this day. That was 12 years ago.
    You know the other crazy thing? I remember all of their names.
    But I'm good.
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